OrganizationActive
Southtown Medical Center, LLC
NPI 1629022058 · Family Medicine Physician · Chicago, IL
Provider details
- NPI number
- 1629022058
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Venkata Vallury, Ceo(773) 284-8601
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- General Practice Physician208D00000X
Allopathic & Osteopathic Physicians
- Pediatrics Physician208000000X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6342 S Pulaski Rd
Chicago, IL 60629-4706
Phone: (773) 284-8601
Street-level locationGet directions
Mailing address
6342 S Pulaski Rd
Chicago, IL 60629-4706
Registry dates
- Enumerated
- 2006-05-20
- Last updated
- 2008-05-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.